Personal Finance: Insurance Policies

Christina Haley of San Marcos, Texas, age 61, recently suffered a severe stroke. She was in intensive care for 12 days and was hospitalized for 18 more days. After being discharged from the hospital, she spent 45 days in a nursing home for medically necessary nursing and rehabilitative care. Christina had a comprehensive health insurance plan through her employer. The policy had a $1000 deductible, a $50,000 episode limit, and a $250,000 annual limit with an 80/20 coinsurance clause with a $2000 coinsurance cap. Christina's policy covered the medically necessary services performed in a nursing home setting. Her total bill was $125,765.

(a) How much of Christina's expenses were paid by her insurance policy?
(b) How much did Christina pay?

Solution Preview

Let's start with how much Christina will pay.

(A)

125,765 - 3,000 that Christina paid = 122,765.
The insurance company will be required to pay for the remainder. Even though there is a $50,000 episode limit, her insurance policy includes a ...

Solution Summary

This solution calculates the amount that Christina will pay for her expenses, and the amount that will be paid by her insurance company. All calculations are shown and explained.